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Innovative Exercise as an Intervention for Older Adults with Knee Osteoarthritis: A Pilot Feasibility Study

  • Erin M. Shellington (a1), Dawn P. Gill (a2), Ryosuke Shigematsu (a3) and Robert J. Petrella (a2)


Exercise has potential to mitigate morbidity in knee osteoarthritis (OA). Participants with knee OA were randomized to a Square-stepping Exercise (SSE) group (2x/week for 24 weeks) or a control group. We assessed the feasibility of SSE and its effectiveness on symptoms (WOMAC), balance (Fullerton), mobility, and walking speed at 12 and 24 weeks. The SSE group had a 49.3% attendance rate and trended toward improvement in the 30-second chair stand at 12 (F = 1.8, p = .12, ηp2 = 0.16), and 24 weeks, (F = 3.4, p = .09, ηp2 = 0.18), and walking speed at 24 weeks, compared to controls. There were no differences in symptoms or balance. The low attendance and recruitment demonstrated limited feasibility of SSE in adults with knee OA. Trends suggest the potential for SSE to improve lower extremity functional fitness and walking speed. SSE should be further studied for effectiveness on symptoms and balance, in addition to improving feasibility.

L’exercice peut diminuer la morbidité associée à l’arthrose du genou. Nous avons réalisé une étude auprès de 22 participants avec arthrose du genou (68 % de femmes) ayant en moyenne 69,5 ans (ÉT : 7,4). Les participants ont été aléatoirement assignés à un groupe d’exercice de marche carrée (square-stepping exercise; SSE; 2 fois/semaine pour 24 semaines) ou à un groupe contrôle. Nous avons évalué la faisabilité (recrutement et présence) du SSE et son efficacité en lien avec les symptômes (WOMAC), l’équilibre (Fullerton), la mobilité (test de la chaise de 30 secondes) et la vitesse de marche après 12 et 24 semaines. Le groupe SSE avait un taux de présence de 49,3% et sa performance au test de la chaise de 30 secondes tendait à s’améliorer après 12 semaines (F=1,8, p=0,12, ηp2=0,16) et 24 semaines (F=3,4, p=0,09, ηp2=0,18), tout comme sa vitesse de marche à 24 semaines (F=2,4, p=0,14, ηp2=0,14), comparativement au groupe contrôle, en contrôlant pour les données de base. Aucune différence n’a été observée sur le plan des symptômes ou de l’équilibre. Les taux de présence et de recrutement faibles indiquent une faisabilité limitée du SSE chez les personnes âgées avec arthrose du genou. Les tendances observées suggèrent que le SSE peut améliorer la fonction du membre inférieur et la vitesse de marche. Les études futures sur le programme SSE devraient se pencher sur son efficacité en lien avec les symptômes et l’équilibre, et viser l’amélioration de sa faisabilité.


Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Robert J. Petrella, M.D., Ph.D. Department of Family Medicine Schulich School of Medicine and Dentistry University of Western Ontario 1495 Richmond Street, Rm. 2102 London ON N6G 2M1 (


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Funds for this study were provided by Mitacs Accelerate in collaboration with Carbylan Therapeutics Inc. to support graduate students (Author EMS in addition to Ashleigh De Cruz and Brendan Riggin) working on this project. The YMCA and the Salvation Army Community Church (Woodstock, Canada) generously donated the space for study intervention and assessments. We would like to acknowledge the YMCA Stoney Creek in London, Canada, and Vikki Williton (YMCA manager). Additionally, this study could not have been carried out with the assistance of Steve Males (YMCA volunteer), Beth Munro (SSE instructor), and Claire Riley (graduate student with Dr. Robert Petrella). Additional thanks to Ashleigh De Cruz, Brendan Riggin, and Narlon C.B.S. Silva for assistance with data collection, data entry, and program implementation. We acknowledge our Square-stepping Exercise volunteers: Megan Graat, Thomas Petrella, Amy Towell, Nicole Conzelmann, Brendan Dodd, Louise Baer, Sylvia Smith, and Nancy Scott. Lastly, we would like to acknowledge the abstract translation to French by Codie Primeau.



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